Defining divergence, disorder, and disability

Note: I define terminology based on the utility of the definitions, preexisting agreed-upon definitions (sometimes including official institutional ones, but centering those by the marginalized groups the terms are referring to), and preexisting general connotations. I acknowledge that my definitions are often imperfect; I appreciate criticism, corrections, and other attempts to fine-tune my definitions to improve them, but please do not expect me to change my underlying methodology (i.e. wanting me to only adhere exactly to definitions handed down by the state or psychiatry or academia, regardless of their utility).

What is a neurodivergence?

In 1998, autistic Australian sociologist Judy Singer coined the term "neurodiversity" in her Honors thesis. U.S. writer Harvey Blume popularized the term in a 1998 issue of The Atlantic. Singer expands on her conceptualization of neurodiversity here: 

Neurodiversity is a subset of Biodiversity

Biodiversity

• is a feature of Earth and its ecosystems
• refers to the total diversity of species that inhabit the planet or its local ecosystems
• was coined in the 1980s as a political term to argue for the conservation of species

Neurodiversity

• is a feature of Earth as a whole, since humans have colonized all Earth's ecosystems 
• refers specifically to the limitless variability of human cognition and the uniqueness of each human mind
• was coined, I believe, by myself in the 1990s, as a political term to argue for the importance of including all neurotypes for a thriving human society

Toward a Neuroqueer Future: An Interview with Nick Walker 

This left autistic activists with the question of how best to describe the nature of our minority status. Being autistic isn’t an ethnicity, gender, sexual orientation, religion, or nationality—so what sort of minority group were we? Autistic scholar Judy Singer, writing on this topic in the late 1990s, provided an answer when she coined the term neurodiversity. Just as humanity is ethnically diverse, and diverse in terms of gender, sexual orientation, and numerous other qualities, humanity is also neurocognitively diverse, and autistics are a neurominority group. I coined the term neurominority a few years after Singer gave us the term neurodiversity; it seemed like an obvious extension of Singer’s concept, and I’m sure others also came up with it independently. Another essential term is neurodivergent, coined by Kassiane Asasumasu somewhere around the year 2000; to be neurodivergent is to diverge from dominant cultural standards of neurocognitive functioning.

From Kassiane's Tumblr, after an attempt at exclusionism:

Actually the coiner of the word does have a tumblr, though it was coined before tumblr. Hi. Twas a neurodivergent woman of color (me. I’m old).

Further, people with mental illness are TOTALLY under the ND umbrella. I, yes I, started using the word because of jackasses using “neurodiverse” to just mean autism & maaaaaybe LDs and such. I’m autistic & epileptic & have mental health cooties & needed a word for ALL OF MY BRAIN, not just the part that already had a movement.

Don’t try to kick people out of my, yes my, category bc you don’t want to be associated with them.

And this more popular post:

I coined neurodivergent before tumblr was even a thing, like a decade or more ago, because people were using ‘neurodiverse’ and ‘neurodiversity’ to just mean autistic, & possibly LDs. But there’s more, like way more, ways a person can have a different yet fucking perfect dammit brain.

Neurodivergent refers to neurologically divergent from typical. That’s ALL.

I am multiply neurodivergent: I’m Autistic, epileptic, have PTSD, have  cluster headaches, have a chiari malformation.

Neurodivergent just means a brain that diverges.

Autistic people. ADHD people. People with learning disabilities. Epileptic people. People with mental illnesses. People with MS or Parkinsons or apraxia or cerebral palsy or dyspraxia or no specific diagnosis but wonky lateralization or something.

The term has since passed into academia.

So what could we define as a "neurodivergence"? Presumably, a specific pattern or collection of neurological and/or mental traits which tend to be observed together and/or have common cause and thus are categorized together as single "conditions" or patterns (i.e. autism, ADHD) which are divergent from the neurotypical norm (so, i.e., statistically or socially/culturally non-normative). As significantly less than fifty percent of the world population is mentally ill, and having a mental illness means having a mind which functions significantly differently from a mentally healthy one, all mental illnesses are neurodivergences.
 

What is a disability?

According to the UN, a disability constitutes “long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder full and effective participation in society on an equal basis with others.” The more approximate layman definition used by disability activists is “something which stops you from being able to do certain things.”

There are plenty of random things which I cannot do. But I do not feel particularly strong desire to do them anyway; my inability to do them does not distress me. Which inabilities are labeled “disabilities” is not determined by objective distress they would cause on average in a vacuum, but rather by which abilities are currently considered necessary according to our current world and culture’s setup and constructions and norms.

Should all disabilities be considered disorders?

Disabilities (usually) cause us distress because the world right now is set up so that people without certain abilities will struggle to get through it. But there is another facet to our distress: ableism.

 

Disabled people are heavily hated and stigmatized. We face violence and abuse from strangers, peers, relatives, authority figures, psychiatry, and other institutions. We are taught that we are wrong and shameful for existing. Many of us internalize that for a long time, and our self-hatred causes us (often severe) distress. Yet should that be considered a disorder in and of itself?

What is a disorder?

According to the APA, a mental disorder is a “health condition involving significant changes in thinking, emotion and/or behavior, and distress and/or problems functioning in social, work or family activities.” The connotation of the term “disorder” is that disorders are bad for us, that curing disorders or treating their symptoms is necessary for us to improve in certain ways health-wise, etc. I use "disorder" as synonymous with "illness," as the APA agrees, and I have yet to see a source or convincing argument as to why they should be distinguished; connotation-wise they seem to carry similar meanings too.

 

Other marginalized people (POC, gay/lesbian/bi/aspec people, etc.) have argued against pathologizing our distress from society’s bigoted treatment of us as “disordered.” The connotation of the label “disorder” implies that we or something within us is the primary problem, rather than society. That to eliminate our distress activists should prioritize “treating” us rather than changing society to treat us better.

 

Are abuse victims “disordered” for experiencing distress from being abused? Similar to the previous paragraph’s example, I think not: claiming we are “disordered” implies it is optimal to try to minimize our currently experienced distress with medication or therapy, rather than simply removing our abusers.

 

Whereas if an abuse survivor has left their abusive situation, but still experiences PTSD (nightmares, flashbacks, now-excessive preemptive risk assessment, etc.), that distress is not going to go away just by environmental changes anymore. The symptoms themselves must be targeted for treatment.
 

This conversation becomes a bit more difficult when we consider that none of us, if we are marginalized, can truly (yet) escape the bigoted society, arguably the ultimate abuser. But like how abuse victims in ongoing abusive situations are capable of recognizing that we are experiencing PTSD which will continue even after we escape, so can marginalized people know that we are experiencing disorders because of society's past treatment of us, which require treatment rather than merely social change to alleviate.

I think from this it is reasonable to conclude that a “disorder” is a condition (i.e. set of traits) which causes significantly severe and persistent (i.e. ongoing, not one-off) distress, the complete alleviation of which requires the removal of the condition’s traits, rather than merely accommodation which does not remove the traits themselves but rather makes it easier and less distressing to live with them by changing the way in which their environment interacts with them.

But do "disorders" actually exist?

A common argument among disorder label abolitionists is that “disorders” do not exist at all, and that the implication they do is offensive because it pathologizes and treats as abnormal reasonable, expected, and/or normal reactions to marginalization and abuse. But they overlook several factors: that marginalization is in itself a non-normative experience (which isn't a bad thing, by the way) and expectedness =/= total normality; that genetic and non-abusive accidental developmental factors' influence can cause disordered traits to present non-normatively; and that the need for treatment to be available to reduce distress remains regardless of cause.

We will not all suddenly become nondisordered the moment capitalism and other oppressive institutions are abolished. To believe so is a vast overgeneralization which speaks over and erases many of our experiences. Even if no one ever abused anyone else anymore, some people would still develop disorders because of genetics or accidental physical traumas. Nor would every neurodivergence's presentation automatically be entirely non-distressing to experience.

Regarding ADHD

For example, my ADHD prevents me from doing things I actually want to do for myself which capitalism and the state aren't telling me to do, such as writing excessively long and complicated discourse essays on Tumblr Dot Com or other projects and work I have in mind, or even recreation. It makes things like personal hygiene, physical health, and necessary work to maintain a livable environment difficult to do. While it would be so much easier to do them without authority figures getting in the way, and I would have so much more time to do so without them telling me to do other unnecessary things which capitalism requires, I would still struggle a lot and benefit greatly from medication, and to erase those struggles would be, in fact, ableist.

Many other ADHDers feel differently, and consider their ADHD a neurodivergence but not a disorder, and not inherently distressing. They are equally valid and equally worthy of consideration, and none of us are objectively wrong about it.

Regarding autism

A while ago, I made a post on Tumblr which gained several hundred notes: I asserted that whether or not someone's autism constitutes a disorder is up to the individual. My post was short, and I only further explored that idea in a few Twitter threads later. But I maintain my stance: not all autistic people have “ASD”; it is very possible to experience autism in a not-inherently-distressing way. It seems that a somewhat larger percentage of autistic people consider their autism nondisordered, compared to ADHDers (though I'm biased here, so please do not take my words as the final arbiter).

I've read posts from autistics who feel their differences in social interpretation are only a problem because allistics are not understanding, and autistics who feel their difficulties connecting and reading cues would still cause a struggle even in an accommodating society. I've read tweets from autistics who if allowed to choose their own sensory environments and to choose not to interact with sensory triggers would find them easy to avoid and no great loss, and autistics who feel their sensory struggles would still be an issue even in a drastically changed world. I've read stories from autistics who only struggle from stimming because of allistics who try to stop them from doing so, and autistics who frequently self-harm to stim, for whom their pain wouldn't go away even if ableism went away. I've read comments from a non-insignificant number of autistic people who claim disorderedness and the ASD label; to erase them, or to imply that them thinking their autism is a disorder = them thinking their autism is bad, is ableist.

I do not consider my autism a disorder, and neither do many of the rest of us. Discussing whether or not autism in general should be considered a disorder by default with alternative identifications as opt-in (i.e. in articles written by neurotypicals), and overall depathologization, are still important parts of our activism—just don't forget that we aren't a monolith while doing so.

Isn't that internalized ableism though?

It's a difficult line to draw sometimes, minimizing harm while also respecting individual choices and agency. I tried my best here:

Some examples of internalized ableism:

• Disorder or disability = morally wrong, shameful, or deserving of stigmatization
• Different = inherently disadvantageous; disadvantageous = inherently undesirable or unworthy of accommodation
• All autism should be "cured"
• I'm "high-functioning" by NT standards, therefore I'm "not autistic enough" or can't be "actually disabled" or struggling
• I'm "low-functioning" by NT standards, therefore my autism automatically should be cured or altered to be "high-functioning"
• Everyone should agree with me that autism is a disorder
• Everyone should agree with me that autism is not a disability
• Functioning or severity labels should be used unironically, uncritically, and universally in NT articles about autism

Not internalized ableism:

• I personally identify with functioning or severity labels, but I understand why other autistics find them harmful or inaccurate, and I do not claim their applicability is universal
• I don't personally consider my autism disabling (i.e. because I'm in an environment where I'm sufficiently accommodated), but I don't see anything wrong with having a disability
• I personally consider my autism disordered, but I don't force that label onto other autistics, and respect them when they say they're nondisordered instead of fakeclaiming them like certain people do
• I am pro a hypothetical way to make autistic people allistic in a future where ableism has been eradicated, but it must be perfectly reversible and should only be applied with informed consent

Regarding depression, anxiety, etc.

I find it very difficult to imagine, personally, a manifestation of depression or anxiety which does not cause significant distress regardless of environment. I don't see anyone (apart from the psych label abolitionists) claiming depression or anxiety can be nondisordered. Nevertheless, if someone comes up with a scenario or describes themself differently convincingly enough, I'm not going to complain.

Regarding psychosis

This thread is interesting:

@deathpigeon

why would it be disordered cognition to have delusions?

it's atypical, but nothing about it is inherently disordered. it's only disordered in how it interacts with one's life and environment, not in itself, and calling it disordered denies the diversity in relations to it.

@NPD_queens

I mean some of my delusions have included

1) me not existing (very distressing)
2) everyone I know trying to kill me (very distressing)

It may be fair to say there are delusions that could be classed as non-disordered, but its also fair to say plenty are disordered.

@deathpigeon

yes, and they're disordered because of your relationship to them, but that doesn't mean that delusions are, or even usually are, disordered cognition, just that they *can* be.

and, like, we've had distressing delusions, like becoming convinced that there are things behind us following us, but, also, we get delusions that brighten our life, like ones about our inhuman nature.

the two aren't particularly distinguishable, so we can't, like, say one is delusions and the other is not, nor does it seem right to describe this thing which causes both distress and fulfilment as disordered because it's more complicated.

@NPD_queens

Yeah, and that is fair enough honestly. I agree. 

Plenty of delusions are non-disordered, but I think the point still stands with the over all thread as long as delusions *can* be disordered at times

Regarding personality disorders (longer post incoming, stay tuned!)
Regarding transness

The problem with incorrect pathologization

Telling those of us with nondisordered neurodivergences, disabilities, and other divergent/non-normative characteristics that we are actually disordered is a denial of our agency. You are like every gaslighting psychiatrist who tells us we aren’t distressed when we actually are, except in reverse; you think you know better than us what we think and what we feel, as if we cannot know that for ourselves because we are too freaky, too insane. You are speaking over us. You are implying that our feelings require "cures" rather than accommodation.

The assumption that everyone with a certain trait must be distressed by it means people claiming to have a nondisordered version of it are either all secretly distressed but in denial, or lying about having that trait in the first place. This forms the basic premise of syscourse.

Pathologization also subjects us to misdirected anti-mental-illness stigma. It makes it easier for the psych industry to research how to "cure" us; it lends further legitimacy to attempts at conversion therapy. Even for actual disorders, treatment and/or cures should be voluntary and only provided with informed consent. (Disclaimer: no, I do not believe we should attempt to destigmatize the above at the expense of actual disorders.)